Nursing Ethical Dilemmas Balancing Morality and Practice

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Introduction

Life is full of ethical dilemmas and almost every day people have to make tough decisions to face their careers, professions, or callings. Whether one is a parent, clergy, spouse, or someone in a professional career like nursing, s/he has to make certain decisions to contain emerging circumstances. My decisions hinge on the values that I hold in life, as a nurse. So what are the values?

Values

Values are a set of beliefs or ideals that are meaningful to a persons life. They underscore ones nature and the kind of judgment s/he makes in life. Thus, every person possesses a set of personal values whether they recognize them or not (Guido, 2009). In essence, these values are the motivational forces behind every success in any professional or vocational life. Moreover, values release fresh energy that propels one into achievements and a morally upright life (Tonnow-Rasmussen, 2011)

My values

Sacrifice and concern for others:  Perhaps the most important value in the nursing profession is a concern for others. As much as we may be overwhelmed with our ambitions and burdens, having more concern for others reenergizes us in our everyday life. It reveals genuine love and cares for others. A nurse has to sacrifice his or her time, especially during odd working hours for the good of the patients. At times, a nurse foregoes family comforts to attend to the patients. The presence of love is the best miracle and medicine that a patient may require at any time in a hospital setting (OBrien, 2011).
Appreciation:  As a nurse, my life and profession are very dear to me. Regardless of any circumstances, I always take a moment to say thank you. I know that if I do not appreciate my life coupled with what I do, there is no way I can serve others wholeheartedly. The positive attitude must resonate from within before I can extend it out to others (Guido, 2009). Patients need someone to assure them that even though they are at their worst moments, they will overcome their present condition, and the best person to give this hope and confidence is a nurse. Consequently, I appreciate every single moment that I have, to appreciate others.
Commitment and devotion:  Nursing is a very sensitive profession and without commitment, one may not be of much help to the patients. Therefore, the loyalty I have towards my profession keeps me motivated when I am unable to perform a certain task or overcome disappointments. Devotion is an equally important value in honoring my professional promises.
Compassion, caring, and tolerance:  These are very important values in the nursing profession. Tolerance reveals ones patience, respect, and civility. Caring for patients too gives them hope, which makes them realize that still there are remnants of caring people who value patients lives. Compassion is another important quality that I cherish in my profession as a nurse, as without compassion, a nurse cannot perform optimally (OBrien, 2011).

How personal values influence our professional decision-making

Personal values are very important tools in our professional decision-making. They determine our objectives and outcomes in life. Rational decisions are a true reflection of the core values in life. When we know our values, we simply need to refer to the factors we considered in the previous decision to make another decision.

Further, apart from informing and influencing the sort of decision that we make, personal values also clarify the fundamental principles of our profession coupled with what we stand for. They relate our decisions to our purpose in life. Values will thus tell one that this particular decision is a priority, while the alternative is not. In addition, they will prompt us to shift our lives in definite directions. Therefore, personal values are the guiding principles in professional decision-making (OBrien, 2011).

Personal values are also effective ideals in making ethical decisions. Professionally, nurses are required to make ethical decisions in their work. Those who have good personal values always make choices based on respect for human rights, equality, and justice. Such nurses are willing to let go of their self-interests to follow their professional principles (Burkhardt, 2008). A rationally constructed decision takes into consideration the outcomes, benefits, usefulness, and impacts of such a decision. Personal values thus provide the best references in solving professional decision dilemmas.

Ethical dilemmas in a nursing profession

As aforementioned, nursing is an extremely delicate and tricky profession. Almost every move is a test for ones patience and philosophy in life. Many times, nurses find themselves in two unpleasant situations. Whether they like it or not, they have to make some choices. The worst end is that, whatever decision they make, it manifests itself in their own lives and those of their patients (Icheku, 2011).

Examples of ethical dilemmas in a nursing profession

Quality of life versus quantity of life

Quality of life responds to the question of a good life. How nurses define good differs from one person to another, but the ethical benchmark is that they have to do good and cause no harm. On the other hand, the quantity of life is based on the idea that it is better to prolong life even if it means compromising the quality of the same life. love life. the dilemma comes in when a nurse has to choose between prolonging a patients those of their pateThe ethical dilemma comes in when a nurse has to choose between prolonging a patients life by compromising the quality of life and letting the patients life end by ignoring the impacts on the affected people (Guido, 2009).

Pro-choice versus pro-life

This dilemma appeals to the personal values of a nurse directly. No matter the circumstances, the decision made directly impacts the nurse personally. Take, for instance, choosing between doing abortion for a patient who has been gang-raped and letting the baby live, or conducting an abortion to save the life of a mother and taking the risk of losing both in the process of saving the baby (Ellis & Hartley, 2003).

Freedom versus control

This ethical dilemma pertains to the rights of the patient. It responds to the question of whether nurses can prevent patients from making choices that harm their lives. For instance, if a patient chooses to stop taking medicine while the nurse knows well that this move would automatically lead to losing the patient, can the nurse force the patient to take the medicine.

Truth-telling versus deception

This ethical dilemma also appeals to the rights of the patient and the personal values of the nurse. Suppose the nurse knows the patient will not survive or needs a treatment that will paralyze some parts of the body and has explained this issue to the family and the familys position is that the patient should not know his medical condition. Is the nurse bound by nursing ethical codes to reveal the truth to the patient or should the nurse respect the familys decision? (Ellis & Hartley, 2003).

A nursing experience when I was faced with an ethical dilemma

My worst experience in the nursing profession happened in 2008. We had a thirty-year-old man in the intensive care unit for over a year because his family was not ready to lose him. Months before his condition worsened, the patient had instructed the hospital to end his life if there were no possibility of him surviving. When it became clear that he could not survive, I attempted to respect his wish and preserve the quality of his life. The family, however, protested and threatened to sue the management if we kept the patients directive. For a year I took care of this man, I saw him a wreath in pain, but that is all I did. In the end, we lost him. I have not forgiven myself for letting him a wreath in pain. I still have a feeling that I could have disobeyed the familys threats and let the patient die in peace.

The ethical Decision-Making model that I applied

I applied the Five Steps of Principled Reasoning by Josephson Institute of Ethics.

Clarity I first clarified the situation at hand together with what I must decide on. There were three options available viz. one, end the life of the patient, two, respect the wish of the family, and three, wait for miracles to happen.
Evaluate Given that it was already clear that the patient could not survive, the best option was to respect the directive by the patient to end his life and preserve the quality of his life. I could explore the second option if the family maintained their threat. The third option was not professional. I automatically ruled it out, though I was aware that miracles happen.
Decide My decision, based on my personal values and the wish of the patient, was to end his life. However, because of external threats, I submitted to the demands of the family.
Implement I did not implement my decision. Instead, I followed the family instructions.
Monitor and modify After the death of the patient, I realized that I made a terrible mistake by bending to the familys demand. It was obvious that the patient would die, and thus leaving him to wreath in pain, in my understanding was not ethical.

Conclusion

Nursing is a very delicate profession. Almost every day nurses have to deal ethical dilemmas, which require prompt decisions. Whether they want or not, they have to make certain decisions that will influence their lives and those of the patients directly. As a nurse, I draw my strength from my personal values. They shape my priorities in life and define how I react to new situations. They also indicate to me whether I am living a moral life, professional life, or something contrary to my principles. When faced with tough ethical dilemmas, I simply refer to them through the ethical decision-making models.

References

Burkhardt, A., & Nathaniel, K. (2008). Ethics & issues in contemporary nursing (3^rd ed.). New York, NY: Thompson Delmar.

Ellis, J., & Hartley, L. (2003). Nursing in Todays World. New York, NY: Lippincott Williams & Wilkins.

Guido, W. (2009). Legal & ethical issues in nursing (5^th ed.). Massachusetts, MA: Pearson.

Icheku, V. (2011). Understanding Ethics and Ethical Decision-Making. Indiana, IN: Xlibris Corporation.

OBrien, M. (2011). Servant leadership in nursing: Spirituality and practice in contemporary healthcare. Sudbury, MA: Jones and Bartlett.

Tonnow-Rasmussen, T. (2011). Personal Value. New York, NY: Oxford University Press.

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